As an Employer, you may have received, or could receive, a notice from the Department of Health and Human Services. You will receive the notice if your employee purchased and was found eligible for advanced payments of the premium tax credit (APTC) or cost-sharing reductions (CSRs) through the Health Insurance Exchange.
The purpose of the notice is to verify the subsidy for the employee and allows you, as an employer, a chance to appeal the eligibility determination of the employee. If certain conditions are met, the employer may be subject to pay an Employer Shared Responsibility Penalty if you are an Applicable Large Employer.
For 2016, the Employer Shared Responsibility Payment will generally apply to Applicable Large Employers with 50 or more full-time equivalent (FTE) employees.
The appeal will NOT determine if your organization has to pay the Employer Shared Responsibility Payment. Only the IRS, not the Health Insurance Marketplace or the Marketplace Appeals Center, can determine which employers are subject to the Employer Shared Responsibility Payment as stated under section 4980 of the Internal Revenue Code.
Below are the options that we can help you to determine how to properly address the notice:
- Take no action when you receive the notice.
- File an appeal to the Marketplace if you believe there has been an error with what is being reported on the notice, which could also eliminate future notices from the IRS.
If you choose to submit an appeal, it must be submitted within 90 days of the date of your Marketplace notice.
If you have received the notice from the Department of Health and Human Services, please contact your local Hawkins Ash CPAs office so we can help you determine the next step you should take.